TOOTH WEAR

Dr. Shahzadi Tayyaba Hashmi

DNT 243

TOOTH WEAR

Definition:‘Tooth wear is defined as loss of tooth tissue due to

causes other than caries’Types: Physiological ( occurs with age) Pathological ( excessive tooth wear) Three types have been described,I. AttritionII. AbrasionIII. Erosion

Causes of tooth wear

ATTRITION

Definition: Attrition is tooth wear caused by tooth-to-tooth contact Occurs as a normal part of aging and it is usually the incisal

edges which wear away first, followed by the occlusal surfaces of molar teeth

Excessive occlusal wear may occur in the following situations:

i. Patients with Bruxism ( excessive grinding of teeth by patients)

ii. Patients who have lost several posterior teeth may show excessive attrition of the anterior teeth, especially if these are used for chewing

iii. Patients who suffer from developmental disturbances of tooth structure, such as Amelogenesis and Dentinogenesis Imperfecta

Examples of attrition

ABRASION

Definition: Abrasion is frictional tooth loss caused by

extrinsic agentsCauses: It is always pathological and may be caused by 1. Tooth brushing2. Biting on a pipe or a pencil3. Tooth brush abrasion is caused by poor

tooth brushing technique

Characteristics of abrasion

It has following characteristics:1. Particularly affects the labial and buccal

surfaces of the maxillary incisor, canine and premolar teeth

2. Resulting cavity is wedge-shaped3. The problem is often compounded by the

use of hard tooth brushes and abrasive toothpaste

Tooth brush abrasion

EROSION

Erosion is the loss of tooth substance caused by chemical agents and is non-bacterial and therefore does not include loss by caries

Most erosion is caused by acids and is seen in following groups:

1. Those with gastric reflux and with bulimia and anorexia. Regurgitation of acid from the stomach particularly affects the palatal surfaces of the maxillary teeth

EROSION

2. As an occupational hazard: Those who work in an acidic environment e.g in

factories making batteries Erosion in these groups is relatively rare but

because the acid is in the environment the erosion is particularly seen on the labial surfaces of both upper and lower incisor teeth

3. Those who consume excessive amounts of carbonated soft drinks or fruit juices. The teeth which are most commonly affected are the palatal surfaces of the upper anterior teeth. Teeth may appear yellow due to reduction in the thickness of enamel. Typically cavities are shallow and broad

Acid erosion by bulimia

Erosion

TREATMENT

Diagnose the most likely cause In many cases the causes may be multiple Abrasion caused by tooth brushing may be

reduced by improving brushing technique A careful history and detailed notes on the

position of erosion are important in order to determine the exact cause

Dietary analysis and advice are essential for those suffering from erosion due to dietary causes